NEW YORK (Reuters Health) - High blood levels of a
naturally occurring enzyme linked to blood vessel function
predict heart-related events and an increased risk of
progressive kidney disease in patients with type 1 diabetes and
kidney disease, according to new research.

The enzyme called ADMA, or asymmetrical dimethylarginine,
inhibits a compound involved in blood vessel dilation. Previous
research has shown that elevated blood levels of ADMA reduce
the ability of the blood vessels to widen, and are also linked
to an increased risk of heart and blood vessel disease.

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Among the type 1 diabetics with kidney disease,
significantly more patients with ADMA levels above the median
(43.4 percent) than similar patients with ADMA levels below the
median (19.4 percent) suffered a fatal or nonfatal major
cardiovascular event, such as a heart attack, the investigators
found.

They also found that patients with ADMA levels above the
median experienced a faster decline in kidney function than
patients with lower ADMA levels. Patients with higher ADMA
levels were 3.2 times as likely as patients with lower ADMA
levels to develop end-stage renal disease, the most advanced
form of kidney disease.

Overall mortality was 67 percent higher among patients with
higher ADMA levels than among patients with lower ADMA levels,
Tarnow and colleagues also report.

If confirmed in other studies, ADMA, or might help doctors
identify type 1 diabetic patients at particularly high risk of
adverse heart and kidney-related events.